尿β2-MG、NAG及RBP联合检验在临床判定乙肝肝硬化患者发生早期肾损伤中应用价值分析  

Urine β the Value of 2-MG,NAG and RBP Combined Test in Clinical Diagnosis of Early Renal Injury in Patients with Hepatitis B Cirrhosis

作　　者：李乐维 齐莹莹 胡亚会 LI Le-wei;QI Ying-ying;HU Ya-hui(Department of Laboratory Medicine,Fifth Clinical School of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou 450000,Henan Province,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)检验科,河南郑州450000

出　　处：《罕少疾病杂志》2024年第9期80-82,共3页Journal of Rare and Uncommon Diseases

基　　金：河南省自然科学基金青年项目(222300420220);河南省医学科技攻关计划联合共建项目(LHGJ20210702)。

摘　　要：目的 探讨尿β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)及视黄醇结合蛋白(RBP)联合检验在临床判定乙肝肝硬化患者发生早期肾损伤中应用价值。方法 选择2021年3月至2023年5月就诊于本院的86例乙肝肝硬化患者,按肾小球滤过率(e GFR)将患者分为两组,40例e GFR值<90 m L/min/1.73m~2者设为合并早期肾损伤组,其余46例e GFR值≥90 m L/min/1.73m~2者设为肝硬化组。留取两组受检者患者晨间第1次尿液10m L,离心取上清液,使用免疫比浊法检测尿NAG、β2-MG和RBP。对比两组尿NAG、β2-MG、RBP水平差异,并绘制受试者工作特征(ROC)曲线,分析尿NAG、β2-MG、RBP单一与联合检测评定乙肝肝硬化患者发生早期肾损伤的价值。结果 合并早期肾损伤组尿NAG、β2-MG、RBP检测值分别为(12.46±3.16)U/L、(2.87±0.71)mg/L、(2.24±0.63)mg/L,均高于肝硬化组的(5.44±1.64)U/L、(0.32±0.09)mg/L、(0.43±0.11)mg/L,有统计学差异(P<0.05)。ROC曲线显示,尿NAG、β2-MG、RBP单一与联合检测评定乙肝肝硬化患者发生早期肾损伤的AUC分别为0.755、0.781、0.765、0.914,灵敏度分别为72.10%、77.90%、75.00%、92.60%,联合检测预测的AUC、灵敏度均高于单一指标(P<0.05)。结论 尿NAG、β2-MG、RBP均是检测乙肝肝硬化患者发生早期肾损伤的有效指标,三者联合检测可提高诊断准确性,值得临床推广。Objective To explore urineβ2 microglobulin(β2-MG),N-Acetyl-β-The value of the combined test of D-glucosaminidase(NAG)and retinol binding protein(RBP)in clinical diagnosis of early renal injury in patients with hepatitis B cirrhosis.Methods 86 patients with hepatitis B cirrhosis who visited our hospital from March 2021 to May 2023 were selected and divided into two groups according to glomerular filtration rate(eGFR),40 cases with eGFR values<90 mL/min/1.73 m²were designated as the group with early renal injury,while the remaining 46 cases with eGFR values≥90 mL/min/1.73 m²were designated as the group with liver cirrhosis.Take 10mL of the first morning urine from two groups of test subjects,centrifuge the supernatant,and use immunoturbidimetry to detect urinary NAGβ2-MG and RBP.Compare the urinary NAG levels between the two groupsβDifferences in levels of 2-MG and RBP,and plot subject operating characteristic(ROC)curves to analyze urinary NAGβThe value of single and combined detection of 2-MG and RBP in evaluating early renal injury in patients with hepatitis B cirrhosis.Results In the group with early renal injury,urinary NAGβThe detection values of 2-MG and RBP were(12.46±3.16)U/L,(2.87±0.71)mg/L,and(2.24±0.63)mg/L,respectively,which were higher than those of the liver cirrhosis group(5.44±1.64)U/L,(0.32±0.09)mg/L,and(0.43±0.11)mg/L,with statistical differences(P<0.05).ROC curve display,urinary NAGβthe AUC of early renal injury in patients with hepatitis B cirrhosis assessed by 2-MG and RBP single and combined detection were 0.755,0.781,0.765 and 0.914,respectively,and the sensitivity was 72.10%,77.90%,75.00%and 92.60%,respectively.The AUC and sensitivity predicted by combined detection were higher than that of a single indicator(P<0.05).Conclusion Urinary NAGβ2-MG and RBP are both effective indicators to detect early renal injury in patients with hepatitis B cirrhosis.The combined detection of the three can improve the diagnostic accuracy,and is worthy of clinical promotion.

关 键 词：乙肝肝硬化 早期肾损伤 β2微球蛋白 N-乙酰-Β-D-氨基葡萄糖苷酶 视黄醇结合蛋白 

分 类 号：R657.31[医药卫生—外科学]